| NPI | 1578082822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L10466) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR A4897) |
| 101YM0800X Counselor Mental Health | |
| 104100000X Social Worker | |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2021-01-11 |