| NPI | 1417213745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00435) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 03861) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |