| NPI | 1851801377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 6885) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 6885) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-06-23 |