| NPI | 1992203624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL MH15465) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH15465) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2019-05-06 |