| NPI | 1497287882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 16238) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA lac-5116) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-07-08 |