| NPI | 1992176523 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.017514)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 29180)  | 
| 1041S0200X Social Worker, School (Licence: IL 2489089)  | |
| Enumeration Date | 2015-10-08 | 
| Last Update Date | 2015-10-08 |