| NPI | 1467605642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-27936) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 374774-3501) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2012-12-27 |