| NPI | 1972098226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 254414) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 241341) |
| 1041C0700X Social Worker Clinical (Licence: IN 99087141A) | |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2019-10-11 |