| NPI | 1760865562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 011579) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 4788) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-04-09 |