| NPI | 1679571301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA SW 2039) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-01-03 |