| NPI | 1104901222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 278-123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 132124) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-08-06 |