| NPI | 1215016332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 000789) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CT 006846) |
| 1041C0700X Social Worker Clinical (Licence: ME 11991) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2009-08-31 |