| NPI | 1942865399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NE 1776) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE P-1462) |
| 101YM0800X Counselor Mental Health (Licence: NE 5164) | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |