| NPI | 1518268002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 3260-123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 548-125) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2010-11-15 |