| NPI | 1669448304 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA CSW004474)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC C000881)  | 
| 1041C0700X Social Worker, Clinical (Licence: GA CSW004474)  | |
| Enumeration Date | 2006-02-23 | 
| Last Update Date | 2022-01-07 |