| NPI | 1891369849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LMSW-17553) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LMSW-17553) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-14 |