| NPI | 1720668429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ LCSW-3408) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LISAC-11825) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |