| NPI | 1063520872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 00001) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IA 064) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |