| NPI | 1295008621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 000643) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA 000659) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-11-06 |