| NPI | 1770051054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-33036) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 33036) |
| 1041C0700X Social Worker, Clinical (Licence: MT 33036) | |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2022-08-31 |