| NPI | 1659823292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW38397) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW38397) |
| 101Y00000X Counselor (Licence: ID LCSW38397) | |
| 103K00000X Behavior Analyst (Licence: ID LCSW38397) | |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2019-07-28 |