NPI | 1740309699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9650-123) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 14349-131) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2021-04-28 |