| NPI | 1821136300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6868-123) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 6868-123) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12079-131) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-02-21 |