| NPI | 1073736617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 160123) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 160123) |
| 101YP2500X Counselor, Professional (Licence: WI 160123) | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist (Licence: WI 160123) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2015-08-31 |