| NPI | 1487810180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL CBHCMS100117) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH15935) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-09-02 |