| NPI | 1477767952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2508) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 4191) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |