| NPI | 1053080002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL 1831C) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL 1831C) |
| 104100000X Social Worker (Licence: AL 1831C) | |
| 251S00000X Community/Behavioral Health (Licence: AL 1831C) | |
| Enumeration Date | 2021-09-12 |
| Last Update Date | 2021-09-12 |