| NPI | 1457597684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 06738) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 7995) |
| 101YM0800X Counselor Mental Health (Licence: IA 6738) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2023-02-16 |