| NPI | 1073864013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-36216) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-36216) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2020-11-30 |