NPI | 1538618558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 13709) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC-5149) |
Enumeration Date | 2016-10-03 |
Last Update Date | 2024-04-12 |