| NPI | 1992105795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: AL 3566G) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AL 3566G) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2015-05-19 |