| NPI | 1710949565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NE 1194) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 675) |
| 101YM0800X Counselor Mental Health (Licence: NE 3012) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-11-09 |