| NPI | 1609032630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 5455) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 5455) |
| 104100000X Social Worker (Licence: SC 5455) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2015-03-31 |