| NPI | 1609309145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C10953) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS AD23-052B) |
| 1041C0700X Social Worker, Clinical (Licence: NC C017267) | |
| 1041C0700X Social Worker, Clinical (Licence: AL 5726C) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-09-08 |