| NPI | 1053979005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11423) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker (Licence: OR A5718) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2024-05-01 |