| NPI | 1578936407 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 13162) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL SW13162) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2023-04-03 |