| NPI | 1942769633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 014306) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105078) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 001526) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2024-09-26 |