| NPI | 1912659467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCSW-LIC-57275) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-48621) |
| 1041C0700X Social Worker, Clinical (Licence: MT BBH-SWLC-LIC-43985) | |
| 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-57275) | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2023-03-29 |