| NPI | 1912992728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV AP00451602) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV 831) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2025-09-11 |