| NPI | 1962161067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 27855) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P018561) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2023-03-28 |