| NPI | 1639725856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 175T00000X Peer Specialist | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2025-08-28 |