| NPI | 1639271844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 1382C) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL 1382C) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 1382C) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-12-22 |