| NPI | 1326645177 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 17495) | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL 1350) | 
| Enumeration Date | 2020-10-05 | 
| Last Update Date | 2020-10-05 |