NPI | 1982018453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60481110) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 12803) |
Enumeration Date | 2014-06-12 |
Last Update Date | 2014-08-25 |