| NPI | 1679067169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9489-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16629-131) |
| 1041C0700X Social Worker, Clinical (Licence: WA LW61093140) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-08-18 |