| NPI | 1013295559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 5646) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 5646) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 5646) | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2024-08-06 |