| NPI | 1982172847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 4153) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 1815-14) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |