| NPI | 1780906768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 4717) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 955) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2012-08-06 |