| NPI | 1548488653 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6542) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL MH6542) | 
| Enumeration Date | 2007-04-23 | 
| Last Update Date | 2021-04-12 |