| NPI | 1366700296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4827) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 172) |
| 1041C0700X Social Worker, Clinical (Licence: KS 7999) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2019-02-06 |