| NPI | 1760716682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34005628A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39001967A) |
| 1041C0700X Social Worker Clinical (Licence: NY 079394) | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2012-05-04 |