NPI | 1295265296 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0135984) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0125808) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2024-07-29 |