| NPI | 1619164217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C005802) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 2060) |
| 101YM0800X Counselor Mental Health (Licence: NC C005802) | |
| 104100000X Social Worker (Licence: NC C005802) | |
| 251S00000X Community/Behavioral Health (Licence: NC C005802) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |