| NPI | 1447012521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1567) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 7317) |
| 1041C0700X Social Worker, Clinical (Licence: CT 15530) | |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2025-08-21 |