| NPI | 1740478650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV DP99454299) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 529) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |