| NPI | 1679802169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0082603) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1026606) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2018-05-04 |