NPI | 1801273909 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV LW61533072) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60067930) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2024-06-05 |