| NPI | 1821479486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 10596) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 5035) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2025-01-30 |