| 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 |