NPI | 1972068112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C013214) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 24810) |
1041C0700X Social Worker, Clinical (Licence: NC P012445) | |
Enumeration Date | 2019-02-01 |
Last Update Date | 2020-09-08 |