NPI | 1407890114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-602) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LMFT-2965) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2009-05-06 |