| NPI | 1881169753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16201-132) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WI 16201-132) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2025-03-10 |