| NPI | 1053833640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SC 11631) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 11631) |
| 101YM0800X Counselor Mental Health (Licence: NC C008245) | |
| 1041C0700X Social Worker Clinical (Licence: NC C008245) | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2018-03-17 |