| NPI | 1376954222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008602) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0710102703) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |