| NPI | 1124020292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC C004983) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC C004983) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2007-11-27 |