| NPI | 1780962829 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7543) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2011-07-22 | 
| Last Update Date | 2022-09-27 |