| NPI | 1194120162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2024-0114) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NM M-08380) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2024-06-13 |