| NPI | 1255305504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 112033) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MA 112033) |
| 1041S0200X Social Worker School (Licence: MA 112033) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2010-06-11 |