| NPI | 1780049593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 076983) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 10096) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2023-09-18 |