| NPI | 1669855060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 226338) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1685 AD) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 16521) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2020-11-13 |