| NPI | 1790172195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW14836) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL ADC0038242014) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-04-20 |