| NPI | 1093231524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW17010) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC P) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2020-02-22 |