| NPI | 1225699424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY 842) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-03-10 |