| NPI | 1417008764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003558) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0812000510) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2018-08-29 |