| NPI | 1730150335 |
|---|---|
| Former Name | OOO OOO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY LCSW617) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY LCSW617) |
| 1041C0700X Social Worker, Clinical (Licence: UT 47649983501) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2013-12-11 |