| NPI | 1972049138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2017033046) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 9544) |
| 104100000X Social Worker (Licence: MO 2015015775) | |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2025-07-10 |