| NPI | 1003192212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW019584) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA SW128684) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2018-03-17 |