| NPI | 1487908992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008868) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL ISW6820) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2018-06-22 |