| NPI | 1215080320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 002652) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 002402) |
| 163W00000X Registered Nurse (Licence: MO 066948) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-01-29 |