NPI | 1346511276 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.012934) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 149.012934) |
Enumeration Date | 2012-01-24 |
Last Update Date | 2012-01-24 |