| NPI | 1306338959 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.019967) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 24233) | 
| 101YM0800X Counselor, Mental Health (Licence: IL 25061) | |
| Enumeration Date | 2018-05-30 | 
| Last Update Date | 2025-06-09 |