| NPI | 1871068395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C11387) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS PH4157) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2024-12-21 |