| NPI | 1639510647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 9751) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150013834) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149016659) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2022-03-25 |