| NPI | 1366236978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-76467) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BB-LAC-LIC-62801) |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-07-15 |