NPI | 1962923102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149018311) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 30967) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2018-05-03 |