| NPI | 1639681075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AL 3820G) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL SW15814) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2023-04-14 |