| NPI | 1003056177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 215113) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-12-11628) |
| 1041C0700X Social Worker, Clinical (Licence: MA 215113) | |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2016-12-09 |