| NPI | 1790506665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC61561577) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHP-R-3205) |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2024-12-30 |