| NPI | 1154105724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 257697) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 257697) |
| 101Y00000X Counselor (Licence: NM SWB-2023-0812) | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2024-12-26 |