| NPI | 1598763088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 000745) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 000995) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-03-22 |