| NPI | 1730602095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 222762) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN 25628) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2020-07-30 |