| NPI | 1013566397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: RI ISW03623) |
| 101YM0800X Counselor Mental Health (Licence: MA LICSW125690) | |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2024-11-25 |