| NPI | 1720420342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 009437) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 001039) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2022-01-24 |