| NPI | 1497123962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 65272) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA CW018728) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2018-03-17 |