| NPI | 1578055778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 101Y00000X Counselor | |
| Enumeration Date | 2018-06-04 | 
| Last Update Date | 2023-11-24 |