| NPI | 1609654565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-SWLC-LIC-73001) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-62924) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2024-11-26 |