| NPI | 1245584333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LCSW76058) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2022-10-25 |