| NPI | 1497157325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OK 6090) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AK 403) |
| 101YM0800X Counselor Mental Health (Licence: OK 5141) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2017-10-03 |