| NPI | 1073203642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 11410) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 29392) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-12-05 |