NPI | 1174069744 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW38786) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LMSW36309) |
Enumeration Date | 2017-01-06 |
Last Update Date | 2023-12-19 |