| NPI | 1215101308 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6145)  | 
| Additional Taxonomies | 104100000X Social Worker | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2008-04-18 | 
| Last Update Date | 2014-05-08 |