| NPI | 1790854420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 5506)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 1041C0700X Social Worker, Clinical (Licence: TN 5583)  | |
| 1041C0700X Social Worker, Clinical (Licence: CA 26436)  | |
| Enumeration Date | 2006-11-07 | 
| Last Update Date | 2021-10-15 |