| NPI | 1538729900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 25821) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA SW0913) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-09-04 |