| NPI | 1902326333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C011007) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC P009312) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 24000) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2021-02-09 |