| NPI | 1720548738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904014402) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 0710103335) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-04-25 |