| NPI | 1982685939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 001903) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 003204) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-07-08 |