NPI | 1427440874 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801100632) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI MCBAP) |
Enumeration Date | 2015-02-23 |
Last Update Date | 2019-02-13 |