| NPI | 1821739095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-SWLC-LIC-55043) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-59080) |
| Enumeration Date | 2022-04-04 |
| Last Update Date | 2024-04-09 |