| NPI | 1639506512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 222873) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2358) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2019-07-23 |