| NPI | 1689255291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9880) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 131302121) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2022-02-21 |