| 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 |