| NPI | 1104175082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH 10005630 SUPV) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW018232) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2015-01-15 |