| NPI | 1366966343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 11215) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 7164) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |