| NPI | 1477997468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 072122) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: SC 6549) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2020-08-17 |