| NPI | 1346457140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2469) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 2509) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |