| NPI | 1801220975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NM X-10350) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 1899) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2018-12-20 |