| NPI | 1679964183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 123196) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 123196) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2023-06-18 |