| NPI | 1578596102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LCSW12488) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW12488) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2011-05-11 |