| NPI | 1629141528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0123254) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 7017-123) |
| 103T00000X Psychologist (Licence: VT 089.0123254) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-08-08 |