| NPI | 1790592061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 23607) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 337825) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |