| NPI | 1558626903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 1020588) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 1020588) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |