| NPI | 1578865648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW11236) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD LCSW14118) |
| 1041C0700X Social Worker, Clinical (Licence: FL SW11236) | |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2013-11-18 |