NPI | 1104426220 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 26341) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041C0700X Social Worker, Clinical (Licence: FL SW22104) | |
1041C0700X Social Worker, Clinical (Licence: DC LC200001248) | |
Enumeration Date | 2020-10-28 |
Last Update Date | 2024-06-11 |