| NPI | 1639789498 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW16470) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW16470) | 
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-08-06 | 
| Last Update Date | 2022-06-02 |