| NPI | 1952956799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV SW071915174) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV SW071915174) |
| 101YM0800X Counselor, Mental Health (Licence: WV SW071915174) | |
| 101YP2500X Counselor, Professional (Licence: WV SW071915174) | |
| 1041C0700X Social Worker, Clinical (Licence: WV SW071915174) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WV SW071915174) | |
| 251S00000X (Licence: WV SW071915174) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WV SW071915174) | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |