| NPI | 1780112771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2017001452)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 9880)  | 
| Enumeration Date | 2017-06-02 | 
| Last Update Date | 2023-07-28 |