| NPI | 1891233409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11732) | 
| Additional Taxonomies | 104100000X Social Worker | 
| 1041C0700X Social Worker, Clinical (Licence: TX 105002) | |
| 1041C0700X Social Worker, Clinical (Licence: MS C11129) | |
| 1041C0700X Social Worker, Clinical (Licence: AR 26349-C) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-22-2105) | |
| Enumeration Date | 2017-02-02 | 
| Last Update Date | 2024-09-17 |