| NPI | 1265055800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11251) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 21-02-10076) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2024-01-11 |