| NPI | 1760930168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904011890) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 58-1716970) |
| 1041C0700X Social Worker Clinical (Licence: NC P011996) | |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2023-04-07 |