| NPI | 1679110605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 17567) |
| 1041C0700X Social Worker, Clinical (Licence: NC C020011) | |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW5535) | |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2026-05-01 |