NPI | 1003013475 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW148) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT107) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2012-08-29 |