NPI | 1316587520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149021972) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
164W00000X Licensed Practical Nurse (Licence: IL 043105752) | |
174H00000X Health Educator | |
Enumeration Date | 2020-01-15 |
Last Update Date | 2020-03-16 |