NPI | 1457814360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.021092) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 33287) |
Enumeration Date | 2019-04-08 |
Last Update Date | 2020-12-15 |