| NPI | 1104083237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 1366) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1095) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2014-11-26 |