| NPI | 1386386761 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YS0200X Counselor, School | |
| 1041C0700X Social Worker, Clinical | |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-07 |