| NPI | 1609004522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5191) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: unlicensed) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-05-04 |