| NPI | 1467900803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 23332) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD G12312) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2021-07-28 |