| NPI | 1326388620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: LCSW)  | 
| 101YM0800X Counselor, Mental Health (Licence: FL SW9350)  | |
| Enumeration Date | 2013-02-22 | 
| Last Update Date | 2022-01-27 |