| NPI | 1770904005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 218954) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 119139) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2015-07-27 |