| NPI | 1174669329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 8608) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 8608) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-06-28 |