| NPI | 1194872663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 104 (educ. psych)) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 201058 (LCSW)) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2025-09-11 |