| NPI | 1871169565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 01708) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 8790) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |