| NPI | 1912426586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2021025415) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MO 2017010560) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-01-27 |