| NPI | 1740855675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17117) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 134952) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2025-01-23 |