| NPI | 1134639768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 122004) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 221551) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2019-06-03 |