| NPI | 1942964382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C014658) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA MSW010129) |
| 101YM0800X Counselor Mental Health (Licence: NC C014658) | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-01-26 |