| NPI | 1184076473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ND 18629) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 18629) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2024-10-04 |