| NPI | 1649255381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 482125) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 2278-123) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-11-17 |