| NPI | 1609904713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW60196792) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR L3200) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-10-09 |