NPI | 1740812619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 128680) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 19900) |
104100000X Social Worker (Licence: MA 225292) | |
Enumeration Date | 2020-02-10 |
Last Update Date | 2024-12-11 |