| NPI | 1457405201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT LCS757) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MT 757) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-01-04 |