| NPI | 1992097570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW- 16038) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LMSW-13140) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2017-04-23 |