| NPI | 1841692027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904014583) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.121484) |
| 104100000X Social Worker (Licence: VA 0903002937) | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2022-12-01 |