| NPI | 1376194191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P014075) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC P014075) |
| 101YP2500X Counselor, Professional (Licence: NC P014075) | |
| 103T00000X Psychologist (Licence: NC P014075) | |
| 106H00000X Marriage & Family Therapist (Licence: NC P014075) | |
| 164W00000X Licensed Practical Nurse (Licence: NC P014075) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC P014075) | |
| 363A00000X Physician Assistant (Licence: NC P014075) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC P014075) | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: NC P014075) | |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-11-05 |