NPI | 1851095384 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-62294) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-55179) |
Enumeration Date | 2023-03-28 |
Last Update Date | 2023-03-28 |