NPI | 1194122879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12843) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 081475-1) |
Enumeration Date | 2014-11-25 |
Last Update Date | 2018-03-17 |