NPI | 1104119122 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011957) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 149011957) |
Enumeration Date | 2011-05-24 |
Last Update Date | 2022-08-22 |