| NPI | 1891102562 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7417) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR L7417) | 
| Enumeration Date | 2014-07-15 | 
| Last Update Date | 2022-06-06 |