| NPI | 1417420696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.103056) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32188) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 150.103056) | |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2023-11-14 |