| NPI | 1699493759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC P018315) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-28463) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-09-20 |