| NPI | 1730143546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 00817) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1540) |
| 1041C0700X Social Worker, Clinical (Licence: NE 808) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2014-04-09 |