| NPI | 1902459845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 161071) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 135820) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2022-03-04 |