| NPI | 1669903266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18121130) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 132114121) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2021-12-10 |