| NPI | 1790796951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC coo3970) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC COO3970) |
| 104100000X Social Worker (Licence: NC COO3970) | |
| 101YM0800X Counselor, Mental Health (Licence: NC COO3970) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-09-18 |