| NPI | 1720306848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT SWP-LCSW-LIC-2419) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC 1347) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2019-10-29 |