| NPI | 1376968818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904014136) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ME CCS7252) |
| 104100000X Social Worker (Licence: NY 085819) | |
| 1041C0700X Social Worker Clinical (Licence: ME LC16061) | |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2024-01-17 |