| NPI | 1558772152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7391) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60463999) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2019-05-29 |