| NPI | 1255877148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9292-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 17909-130) |
| 104100000X Social Worker (Licence: WI 130498-121) | |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2021-04-08 |