| NPI | 1407225543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088921) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA SW132519) |
| 101YM0800X Counselor, Mental Health (Licence: NY 094887-1) | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2020-03-30 |