| NPI | 1821603390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 103661) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL 149.022484) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2023-06-05 |