| NPI | 1265552475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 006965) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 003090-1) |
| 101YP2500X Counselor Professional (Licence: CT 000401) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2016-05-12 |