| NPI | 1760725634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8415-123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 16757-130) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2021-04-22 |