| NPI | 1720311673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 104387) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: WV BP00944020) | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical (Licence: WV DP00944020) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2024-08-13 |