| NPI | 1104171032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I 1101251) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I 1101251) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |