| NPI | 1154489755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 125439) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 225627) |
| 101YM0800X Counselor, Mental Health (Licence: MA 125439) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-01-30 |