| NPI | 1619308194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09924033) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD0000390) | |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2023-01-30 |