| NPI | 1003100207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: I.0002726-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0001482-SUPV) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |