| NPI | 1962594218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW9912) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 6683335-3506) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2019-06-26 |