NPI | 1477023653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801118782) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI SA0090077) |
Enumeration Date | 2018-11-29 |
Last Update Date | 2024-08-18 |