| NPI | 1184784589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW2452) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LCSW2452) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-03-22 |