| NPI | 1366956617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NE 638) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 25) |
| Enumeration Date | 2017-11-24 |
| Last Update Date | 2017-11-24 |