| NPI | 1578947537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW21601) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA CG60583971) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2024-01-31 |