| NPI | 1194378364 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 104100000X Social Worker | 
| 225800000X Recreation Therapist | |
| Enumeration Date | 2019-07-17 | 
| Last Update Date | 2019-07-17 |