| NPI | 1679657092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 912) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NE 419) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |