| NPI | 1275948721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 095) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 4621) |
| 1041C0700X Social Worker, Clinical (Licence: KS 9049) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2017-03-29 |