| NPI | 1366990491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 10580) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2019-04-11 |