NPI | 1821783788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 14246649-3501) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
251S00000X Community/Behavioral Health | |
104100000X Social Worker (Licence: IL 150109062) | |
Enumeration Date | 2023-04-06 |
Last Update Date | 2025-10-01 |