| NPI | 1306270459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 17039) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 17039) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2014-08-13 |