NPI | 1679142632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P0161100) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC P016100) |
101YM0800X Counselor, Mental Health (Licence: NC P016100) | |
Enumeration Date | 2021-06-23 |
Last Update Date | 2021-07-12 |