| NPI | 1295227452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TN 7528) |
| 1041C0700X Social Worker Clinical (Licence: IL 149.022284) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2020-12-14 |