| NPI | 1104129931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL 8966) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2024-01-02 |