| NPI | 1356498463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005106) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH S0026020) | 
| Enumeration Date | 2007-01-04 | 
| Last Update Date | 2014-04-25 |