NPI | 1023008935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 0890074344) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 057211-1) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2012-05-31 |