| NPI | 1235513680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 18501) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 18501) |
| 1041C0700X Social Worker, Clinical (Licence: FL ISW 9575) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2022-04-29 |