| NPI | 1275374357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 124535) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 124535) |
| 101YP2500X Counselor, Professional (Licence: IA 124535) | |
| 103TC0700X Psychologist, Clinical (Licence: IA 124535) | |
| 106H00000X Marriage & Family Therapist (Licence: IA 124535) | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-06-04 |