| NPI | 1730428525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.021575)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 1041C0700X Social Worker, Clinical (Licence: MN 24555)  | |
| Enumeration Date | 2013-02-14 | 
| Last Update Date | 2021-04-13 |