| NPI | 1285736108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904005126) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0904005126) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2010-11-19 |