| NPI | 1295059970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV CP00940811)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV CP00940811)  | 
| 106H00000X Marriage & Family Therapist (Licence: WV CP00940811)  | |
| Enumeration Date | 2010-03-24 | 
| Last Update Date | 2014-12-10 |