NPI | 1417001975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 724LCSW) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 264LMFT) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2007-07-08 |