| NPI | 1871852681 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7010) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I.1200470) | 
| Enumeration Date | 2012-05-14 | 
| Last Update Date | 2022-03-30 |