| NPI | 1104815687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW5803) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT2052) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2019-08-25 |