| NPI | 1164571006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2012010106) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 4552) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-02-04 |