| NPI | 1710092176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5174) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR L5174) |
| 101YM0800X Counselor, Mental Health (Licence: WA LW00004479) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-01-27 |