| NPI | 1275912487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 57547) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 24562) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 4294) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2022-11-04 |