| NPI | 1689132524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 008339) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 19030) | |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-06-29 |