| NPI | 1962771915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 4457) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL SW24208) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2025-02-24 |