| NPI | 1871183467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW18032) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL SW18032) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL SW18032) | |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-01-19 |