| NPI | 1194079103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NJ 44SC05656600) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: UT 8273583-3502) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2015-11-20 |