| NPI | 1053610535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 5893) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TN LPC0000003478) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2016-04-06 |