NPI | 1720528821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2018007941) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2015003421) |
Enumeration Date | 2017-03-08 |
Last Update Date | 2020-09-09 |