| 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 |