| NPI | 1396167177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3367) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 126734-121) |
| 1041C0700X Social Worker, Clinical (Licence: WI 8168-123) | |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2016-06-23 |