| NPI | 1780809558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 17169) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical (Licence: MA 11110) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 25913) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2021-08-19 |