| NPI | 1740820026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 4418) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI 1981-18) |
| 101YM0800X Counselor Mental Health (Licence: HI 4418) | |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |