| NPI | 1639703887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11752) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 21-QMHP-R-0533) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2024-08-12 |