| NPI | 1477904597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2019045963) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2017027929) |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-01-04 |