| NPI | 1497209084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA LICSW121717) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 221895) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-09-26 |