NPI | 1295119253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.017394) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30691) |
Enumeration Date | 2015-07-18 |
Last Update Date | 2021-05-25 |