| NPI | 1164940318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904012767) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180010077) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149017695) | |
| 1041C0700X Social Worker, Clinical (Licence: WV DP00945674) | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2023-09-28 |