| NPI | 1659743664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 33007540A) |
| 101YM0800X Counselor, Mental Health (Licence: KY 252224) | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2019-01-07 |