| NPI | 1992747828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 000609) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 761) |
| 1041C0700X Social Worker, Clinical (Licence: MO 001404) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-09-11 |