| NPI | 1346411956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6801097538) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC C005919) |
| Enumeration Date | 2008-03-22 |
| Last Update Date | 2015-03-11 |