| NPI | 1609233501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 5142) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10770) |
| 1041C0700X Social Worker, Clinical (Licence: NE 7037) | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2018-10-02 |