| NPI | 1104380849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW16444) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TH0004X Psychologist, Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2020-03-11 |