| NPI | 1730673914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 112729) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 09927421) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical (Licence: CO 09927421) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2022-06-09 |