| NPI | 1245631233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 118464) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL SW19872) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2023-03-30 |