| NPI | 1598036600 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34012095A)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 2010-R)  | 
| 101YP2500X Counselor, Professional (Licence: GA 006663)  | |
| Enumeration Date | 2012-01-20 | 
| Last Update Date | 2025-10-09 |