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 |