| NPI | 1962581280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ 12284) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3079) |
| 1041C0700X Social Worker Clinical (Licence: NE 1209) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-10-07 |