| NPI | 1407392111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW13760) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2018-11-28 |