| NPI | 1598829897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 3613) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 2) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 12133) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-06-01 |