| NPI | 1760508113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4852-125) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 96397-030) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2016-05-10 |