NPI | 1629335666 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 10760) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-04-16 |
Last Update Date | 2019-09-19 |