| NPI | 1184825119 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LPC-3833) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LSW-24541) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |