| NPI | 1861874752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8331-123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN 21224) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-06-26 |