| NPI | 1417220468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 12151) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL IMH9464) |
| 1041C0700X Social Worker Clinical (Licence: FL IMH9462) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2014-12-17 |