| NPI | 1306192208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA CW019687) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 15257) |
| 101YM0800X Counselor, Mental Health (Licence: DC LC50079476) | |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2018-06-22 |