| NPI | 1104990282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 100) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 501) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-01-22 |