| NPI | 1801164819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO CSW.09923452) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 9995120) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2018-10-31 |