| NPI | 1780279596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904012488) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 2932) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2021-07-30 |