| NPI | 1720516958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 255884) |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical (Licence: FL 16590) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2023-06-29 |