| NPI | 1902448657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 256144) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WV DP00946393) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2025-05-01 |