| NPI | 1649483892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3496) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 3496 LCSW) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |