NPI | 1942602040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8304-123) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15772-132) |
Enumeration Date | 2014-09-19 |
Last Update Date | 2020-03-27 |