| NPI | 1306500699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9833) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16521-131) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker (Licence: WI 128150) | |
| Enumeration Date | 2021-10-24 |
| Last Update Date | 2023-07-11 |