| NPI | 1770990566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC CO14818) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical (Licence: CO CSW.09925062) | |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2023-08-09 |