| NPI | 1104114248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 1494) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1229) |
| 101YM0800X Counselor, Mental Health (Licence: NE 4223) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-10-19 |