| NPI | 1073678876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 004173) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 000272) |
| 101YM0800X Counselor, Mental Health (Licence: MO 000272) | |
| 101YP2500X Counselor, Professional (Licence: MO 000272) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-09-06 |