| NPI | 1588006795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-SWLC-LIC-64292) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2023-09-20 |