| NPI | 1528396116 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW 00992540)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 115275)  | 
| Enumeration Date | 2009-11-19 | 
| Last Update Date | 2016-01-26 |