| NPI | 1922294040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7122-123) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 7122-123) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |