| NPI | 1487211215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-05-28 | 
| Last Update Date | 2021-04-21 |