NPI | 1316208192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-0007470) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166-000510) |
Enumeration Date | 2012-06-07 |
Last Update Date | 2012-06-07 |