| NPI | 1780217687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 10118-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 150104309) |
| 104100000X Social Worker (Licence: WI 132272) | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-03-13 |