| NPI | 1437532454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19435130) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149017783) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2021-04-28 |