| NPI | 1063775468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW61017460) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: WA LW61017460) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-08-27 |