| NPI | 1982898920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 00001867) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 1867) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2018-06-25 |