| NPI | 1982203170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-44208) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCSW-LIC-44208) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-03-15 |