| NPI | 1194162495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9567) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 3200) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2022-06-15 |