| NPI | 1508287780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8563) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 8563-123) |
| Enumeration Date | 2013-12-14 |
| Last Update Date | 2016-09-20 |