| NPI | 1578892204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904004398) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0812000173) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2021-03-17 |