| NPI | 1215449848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904009724) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2019-02-22 |