| NPI | 1063873206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 2618) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2015016657) |
| 1041C0700X Social Worker, Clinical (Licence: KS LCPC) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2020-10-21 |