| NPI | 1871147918 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2019-07-26 | 
| Last Update Date | 2019-07-26 |