NPI | 1013514587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC 1013514587) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC P15282) |
261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC P15282) | |
Enumeration Date | 2020-10-07 |
Last Update Date | 2022-02-01 |