NPI | 1558713941 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 12264880-3501) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-40093) |
Enumeration Date | 2016-07-08 |
Last Update Date | 2024-08-01 |