| NPI | 1548320823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005697) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 1041C0700X Social Worker, Clinical (Licence: SC 8654) | |
| 1041C0700X Social Worker, Clinical (Licence: NC C004844) | |
| 1041C0700X Social Worker, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 363AM0700X Physician Assistant, Medical (Licence: GA 005697) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2024-08-14 |