| NPI | 1609804483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MS C0368) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MS C0368) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-08-13 |