| NPI | 1750736534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NE 7057) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 10838) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |