NPI | 1831644525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 25668) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.017829) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 31863) | |
Enumeration Date | 2016-08-23 |
Last Update Date | 2020-09-30 |