| NPI | 1144566597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 009624) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CT 009624) |
| 103TF0000X Psychologist, Family (Licence: CT 009624) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CT 009624) | |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2018-03-17 |