| NPI | 1710581566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC P020910) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2024-08-17 |