NPI | 1104378595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09927332) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LMSW36079) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2022-04-07 |