| NPI | 1407454531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19205) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 13196) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |