| NPI | 1780806539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 2243-123) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180-004984) |
| 101YM0800X Counselor Mental Health (Licence: IL 180-004984) | |
| 101YP2500X Counselor Professional (Licence: IL 180-004984) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-03-17 |