| NPI | 1962746768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C007960) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 2608) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-2608) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2022-08-11 |