| NPI | 1053612648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ID LCSW-30131) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LCSW-30131) |
| 101YM0800X Counselor Mental Health (Licence: ID LCSW-30131) | |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2010-11-12 |