| NPI | 1043593973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 336) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WY 336) |
| 1041C0700X Social Worker, Clinical (Licence: WY 336) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2012-02-01 |