| NPI | 1922299163 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 55)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00562)  | 
| 101YM0800X Counselor, Mental Health (Licence: NE 2543)  | |
| Enumeration Date | 2007-08-05 | 
| Last Update Date | 2021-03-30 |