| NPI | 1467552513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009774) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 1111) |
| 1041C0700X Social Worker, Clinical (Licence: WI 3329) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-07-30 |