| NPI | 1619221710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ LCSW-17502) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical (Licence: KY 252917) | |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2020-08-24 |