| NPI | 1407410418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 9117-123) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2021-04-13 |