| NPI | 1164725404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 104100000X Social Worker (Licence: FL CBHCMS100759) | 
| Enumeration Date | 2010-12-08 | 
| Last Update Date | 2019-06-03 |