| NPI | 1164099081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 15431) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 6126) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2025-01-07 |