| NPI | 1124039821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904001518) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0904001518) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-06-17 |