| NPI | 1114622495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 12282-123) |
| Additional Taxonomies | 104100000X Social Worker |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2025-04-15 |