| NPI | 1750915047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 11729) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health (Licence: WV 11729) | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2024-07-30 |