NPI | 1023131752 |
---|---|
Former Name | WILLIE J. LOVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN LICSW #5348) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT # 0602) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2007-07-09 |