| NPI | 1386948412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C009981) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-22785) |
| 104100000X Social Worker (Licence: NY 089063) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2021-10-04 |