NPI | 1043205073 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000079) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000070) |
106H00000X Marriage & Family Therapist (Licence: VA 0717000902) | |
Enumeration Date | 2005-09-15 |
Last Update Date | 2008-07-01 |