NPI | 1518166362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904009364) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AL L299) |
1041C0700X Social Worker, Clinical (Licence: AL 2121C) | |
Enumeration Date | 2007-07-12 |
Last Update Date | 2016-07-22 |