| NPI | 1558914085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 129061) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19066-130) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2021-06-29 |