| NPI | 1770661902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 11034) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 11034) |
| 1041C0700X Social Worker, Clinical (Licence: CO 354) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-05-10 |