| NPI | 1770716805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149005288) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 149005288) |
| 101YP2500X Counselor, Professional (Licence: IL 149005288) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |