| NPI | 1679088843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 12788) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 12788) |
| Enumeration Date | 2017-12-09 |
| Last Update Date | 2020-09-08 |