| NPI | 1194092007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR L6394) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: WI 128563-121) |
| 1041C0700X Social Worker Clinical (Licence: OR A3133) | |
| Enumeration Date | 2011-11-20 |
| Last Update Date | 2020-04-21 |