| NPI | 1235213612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW9199) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TX 33987) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2015-07-27 |