| NPI | 1053959601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 11435466-3501) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 11435466-3502) |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2022-03-07 |