NPI | 1245303155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA LCSW 461) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA LMFT 198) |
Enumeration Date | 2006-11-16 |
Last Update Date | 2007-07-08 |