| NPI | 1619664778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904015187) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103060) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0732010120) | |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-10-10 |