| NPI | 1336587575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2017025345) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2024-10-09 |