| NPI | 1952452039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C006395) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2024-07-31 |