| NPI | 1861402109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT SWP-LCSW-LIC-709) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-1065) |
| 1041C0700X Social Worker, Clinical (Licence: WY LCSW-760) | |
| 1041C0700X Social Worker, Clinical (Licence: OR L7004) | |
| 106H00000X Marriage & Family Therapist (Licence: MT SWP-LMFT-LIC-91) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-06-02 |