| NPI | 1164959607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 9688) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 9688) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-05-15 |