NPI | 1386161131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 149017964) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 149017964) |
251S00000X (Licence: IL 149017694) | |
261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 149017694) | |
Enumeration Date | 2017-08-23 |
Last Update Date | 2020-07-23 |