| NPI | 1902376643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA 122650502) |
| 1041C0700X Social Worker, Clinical (Licence: PA CW021907) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2021-06-25 |