| NPI | 1265906259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 23814) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 23814) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 23814) | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |