| NPI | 1952508574 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C105460) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW6116) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 1428) | |
| Enumeration Date | 2007-06-28 | 
| Last Update Date | 2019-03-14 |