| NPI | 1922489954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 05955) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 00822) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2023002041) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2023-02-06 |