NPI | 1861756413 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS LSCSW 4590) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1066) |
Enumeration Date | 2012-06-28 |
Last Update Date | 2016-10-24 |