| NPI | 1053966101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 101Y00000X Counselor | |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |