| NPI | 1194261529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2016000202) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2016000202) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2016000202) | |
| 1041C0700X Social Worker, Clinical (Licence: MO 2016000202) | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |