| NPI | 1629694633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 11748) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 098953) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |