| NPI | 1649418492 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2005004554)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149020727)  | 
| 101YM0800X Counselor, Mental Health (Licence: MO 2005004554)  | |
| Enumeration Date | 2009-02-02 | 
| Last Update Date | 2024-06-19 |