| NPI | 1497312748 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013613)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 3236)  | 
| 1041C0700X Social Worker, Clinical (Licence: NC C014529)  | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25492)  | |
| Enumeration Date | 2019-05-22 | 
| Last Update Date | 2022-04-05 |