| NPI | 1700280567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C011162) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-15442) |
| 104100000X Social Worker | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2020-06-01 |