| NPI | 1568089423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L11164) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 21-05-10131) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2024-01-23 |