NPI | 1558870808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L8444) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 24-01-20374) |
Enumeration Date | 2017-09-28 |
Last Update Date | 2024-05-20 |