NPI | 1417251000 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904002274) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0812000404) |
Enumeration Date | 2010-12-22 |
Last Update Date | 2010-12-22 |