| NPI | 1518374040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 120713) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2018-08-09 |