| NPI | 1104931021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 2744-125) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 879-121) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |