| NPI | 1932685161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 110361) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 19017) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2022-01-05 |