| NPI | 1972739142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 119161) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 1041C0700X Social Worker Clinical (Licence: PA CW017871) | |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2015-11-20 |