| NPI | 1467873323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801095909) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C02843) |
| 101YM0800X Counselor Mental Health (Licence: MI 6801095909) | |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2020-11-04 |