| NPI | 1700969557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 640) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 815) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |