| NPI | 1598974396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 204070) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 204070) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2009-04-08 |