| NPI | 1710769187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P019771) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 29470) |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-19 |