| NPI | 1659639581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 222929) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YM0800X Counselor, Mental Health (Licence: MA 222929) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2019-12-10 |