| NPI | 1326099706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SC 2212) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 410155) |
| 101YM0800X Counselor Mental Health (Licence: SC 606) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 193) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-07-19 |