| NPI | 1790177145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: MD 17589) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 17589) |
| 1041C0700X Social Worker, Clinical (Licence: MD 17589) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 17589) | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2025-09-24 |