| NPI | 1164479549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 1119) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC LPC #2567) |
| 104100000X Social Worker (Licence: SC LMSW #1119) | |
| 106H00000X Marriage & Family Therapist (Licence: SC LMFT #2295) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-11-09 |