| NPI | 1508294604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.016012) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 149.016012) |
| 101YM0800X Counselor Mental Health (Licence: IL 149.016012) | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2019-05-07 |