| NPI | 1629830930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904017485) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 0904017485) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-10-07 |