NPI | 1356639983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801094190) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2011-07-18 |
Last Update Date | 2022-07-21 |