| NPI | 1770686057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C009070) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 7168) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-06-30 |