| NPI | 1063653087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 1153) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: KS 5673) | |
| 104100000X Social Worker (Licence: WY 1153) | |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2024-06-12 |