| NPI | 1164418380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD 436) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 436) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-07-08 |