| NPI | 1134330582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 14090) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD G11539) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-07-27 |