| NPI | 1164827366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |