| NPI | 1972891521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 2011016671) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2011016671) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2016-06-20 |