NPI | 1386034239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 1386034239) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6801095863) |
Enumeration Date | 2015-01-30 |
Last Update Date | 2023-12-21 |