| NPI | 1730204892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2003026254) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2003026254) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-11-12 |