| NPI | 1255684049 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW22857) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC P006702) | 
| Enumeration Date | 2012-10-18 | 
| Last Update Date | 2024-10-25 |