| NPI | 1487736005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: 6801065264) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6801065264) |
| 101YM0800X Counselor Mental Health (Licence: MI 6801065264) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-01-02 |