NPI | 1902331200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801108146) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
1041C0700X Social Worker, Clinical (Licence: NJ 44SL06861900) | |
Enumeration Date | 2017-04-24 |
Last Update Date | 2025-07-15 |