| NPI | 1043198302 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA SW140020) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |