| 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 |