| NPI | 1003078775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC18002) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY R043885) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-08-06 |