| NPI | 1346223740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 481125) |
| 1041C0700X Social Worker, Clinical (Licence: WI 1674123) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2007-07-08 |