| NPI | 1063714400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 9284) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA MSW002230) |
| 104100000X Social Worker (Licence: GA MSW002230) | |
| 1041C0700X Social Worker Clinical (Licence: MD 24811) | |
| 1041C0700X Social Worker Clinical (Licence: GA 004825) | |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2019-06-28 |