| NPI | 1821118712 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 10177) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL ISW3929) | 
| 1041C0700X Social Worker, Clinical (Licence: PA CW016175) | |
| Enumeration Date | 2007-04-02 | 
| Last Update Date | 2022-12-30 |