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 |