| NPI | 1790844231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW013355) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA LPC 1606) |
| 101YP2500X Counselor, Professional (Licence: PA PC006403) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-12-04 |