| NPI | 1912250051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LMSW32402) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LMSW32402) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2013-06-28 |