| NPI | 1003019274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV 172) |
| 101YM0800X Counselor, Mental Health (Licence: WV 172) | |
| 106H00000X Marriage & Family Therapist (Licence: WV 172) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2015-12-15 |