| NPI | 1548643075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 21052) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 21052) |
| 101YM0800X Counselor, Mental Health (Licence: MD 21052) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2019-04-26 |