| NPI | 1629451737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 003113) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 003113) |
| 101YM0800X Counselor Mental Health (Licence: IL 149.018867) | |
| 101YP2500X Counselor Professional (Licence: MO 003113) | |
| 101YP2500X Counselor Professional (Licence: IL 149.018867) | |
| 103TC1900X Psychologist Counseling (Licence: MO 003113) | |
| 103TC1900X Psychologist Counseling (Licence: IL 149.018867) | |
| 1041C0700X Social Worker Clinical (Licence: IL 149.018867) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-01-09 |