| NPI | 1316941081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 14341) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1745) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-08-02 |