| NPI | 1619459807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C014030) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-24670) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904016536) | |
| 1041C0700X Social Worker, Clinical (Licence: CT 58.013449) | |
| 1041C0700X Social Worker, Clinical (Licence: SC TLS.337.CP) | |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2024-04-29 |