| NPI | 1548513187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 092177) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO CSW.09923106) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000305) | |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2018-09-14 |