| NPI | 1134783632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: PA CW020666) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA SW130909) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2021-05-25 |