| NPI | 1629338389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 10402) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 755) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2021-02-18 |