| NPI | 1619462942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 18013-130) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C013842) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-07-26 |