| NPI | 1679623763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AR 7144-C) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical (Licence: TN LSW0000004502) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-05-16 |