| NPI | 1336688902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 012096) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32996) |
| 104100000X Social Worker (Licence: IL 150.101987) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149019336) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2022-05-12 |