| NPI | 1871695155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904008661) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TN CMSW6264) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2016-03-23 |