| NPI | 1649820622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 131057121) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 131057121) |
| 101YM0800X Counselor Mental Health (Licence: WI 131057-121) | |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2022-10-19 |