| NPI | 1184098865 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 1242)  | 
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR 1242)  | 
| Enumeration Date | 2015-11-18 | 
| Last Update Date | 2021-08-08 |