| NPI | 1467725648 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW10711) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL SW10711) | 
| 1041S0200X Social Worker, School (Licence: FL SW10711) | |
| Enumeration Date | 2012-02-17 | 
| Last Update Date | 2012-12-18 |