| NPI | 1972063600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001599A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33008381A) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |