| NPI | 1679683924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 77360) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA CSW003833) |
| 1041C0700X Social Worker, Clinical (Licence: MD 13176) | |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW003833) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-06-09 |