NPI | 1831696608 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 3945C) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AL 3945C) |
Enumeration Date | 2018-04-09 |
Last Update Date | 2020-10-15 |