| NPI | 1104371053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AL 4589C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN LSW0000010773) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2020-12-08 |