| NPI | 1275106312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 27347) |
| 1041C0700X Social Worker, Clinical (Licence: NC C016920) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2024-04-03 |