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 |