| NPI | 1316248297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904002867) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0812000066) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |