| NPI | 1609428630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM SWB-2022-0054) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM CSA0203271) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CSA0203271) | |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2022-12-09 |