| NPI | 1457968794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD CSW5137) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: SD CSW5137) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2022-03-10 |