| NPI | 1528139946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 8038) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 188LCPC) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2014-06-17 |