| NPI | 1720135031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2015021851) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY R047239-1) |
| 1041C0700X Social Worker Clinical (Licence: NY R047239) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2017-12-05 |