| NPI | 1710316054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005073) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA MSW005467) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2017-01-30 |