| NPI | 1972218717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID 8911162) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 42824) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2026-07-13 |