| NPI | 1164425674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL PIP370-1246C) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2005-05-30 |
| Last Update Date | 2007-07-08 |