| NPI | 1629373873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 2043) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 202785) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2013-10-16 |