| NPI | 1720619570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 12114) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 7447) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-01-30 |