NPI | 1194893966 |
---|---|
Former Name | GWEN GOLDENMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI LCSW438123) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI MFT366124) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2007-07-08 |