| NPI | 1275116576 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 18377)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA Cw024038)  | 
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06388400)  | |
| Enumeration Date | 2021-05-04 | 
| Last Update Date | 2025-01-02 |