| 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 |