| NPI | 1518029602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 004019) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 004019) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-08-29 |