| NPI | 1831629997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 7061) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 10414) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2020-07-21 |