| NPI | 1164964367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 03076) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 03076) |
| 1041S0200X Social Worker, School (Licence: MD 03076) | |
| 106H00000X Marriage & Family Therapist (Licence: MD 03076) | |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2016-11-06 |