| NPI | 1538552377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121142) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 10340) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 220502) | |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2023-01-04 |