| NPI | 1609053214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WV DP00942603) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2020-10-14 |