| NPI | 1205812484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 1314483501) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: UT 1314483102) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-07-08 |