| NPI | 1275531741 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2003020116) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2003020116) | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2022-04-11 |