| NPI | 1255719712 |
|---|---|
| Professional Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15170) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical (Licence: FL 15170) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2019-02-20 |