| NPI | 1134412711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 70191303501) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2022-01-19 |