| NPI | 1659026219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 79117) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 64306) |
| Enumeration Date | 2022-02-12 |
| Last Update Date | 2025-04-17 |