| NPI | 1154744423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 2137) |
| 1041C0700X Social Worker Clinical (Licence: NE 1820) | |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2022-07-20 |