| 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 Community/Behavioral Health (Licence: IL 149017694) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 149017694) | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2020-07-23 |