| NPI | 1508382458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL 4640C) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AK 3620G) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |