NPI | 1962777284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009552) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS20725) |
1041C0700X Social Worker, Clinical (Licence: FL SW19175) | |
1041C0700X Social Worker, Clinical (Licence: SC 14711) | |
Enumeration Date | 2012-03-20 |
Last Update Date | 2025-02-03 |