| NPI | 1629023312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2061) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 950) |
| 1041C0700X Social Worker, Clinical (Licence: IA 06785) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2014-05-13 |