NPI | 1679036529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 18676) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AC1734) |
Enumeration Date | 2019-04-08 |
Last Update Date | 2019-06-11 |