| NPI | 1811260599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 009193) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 1078) |
| 1041C0700X Social Worker Clinical (Licence: NC C015580) | |
| Enumeration Date | 2012-02-11 |
| Last Update Date | 2024-01-04 |