| NPI | 1679016299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 128459) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 128459) |
| 104100000X Social Worker (Licence: WI 128459) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17987) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 128459) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 128459) | |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2020-10-08 |