| NPI | 1487199477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C011739) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 20604) |
| 101YP2500X Counselor Professional (Licence: NC A13559) | |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2020-01-19 |