| NPI | 1588132187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1559) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 11135) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |