| NPI | 1992045579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 128914-121) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2018-08-14 |