| NPI | 1578780748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SC 4602) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 1707) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |