| NPI | 1215378047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L6097) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OR C4084) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2019-11-14 |