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 |