| NPI | 1245617752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW17298) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical (Licence: MA LICSW126682) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2023-08-18 |