| NPI | 1568942670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 15211) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC6571) |
| 104100000X Social Worker (Licence: NJ 44SL06548000) | |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2025-07-10 |