| NPI | 1679988539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: DE Q10001297) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3608) |
| 101YM0800X Counselor Mental Health (Licence: VT 08901358TELE) | |
| 1041C0700X Social Worker Clinical (Licence: MD 32493) | |
| 1041C0700X Social Worker Clinical (Licence: SC TLS1206CP) | |
| 1041C0700X Social Worker Clinical (Licence: UT 1372861693501) | |
| 1041S0200X Social Worker School (Licence: NJ 44SC06515800) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2025-07-29 |