NPI | 1598063315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 4800) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 784) |
Enumeration Date | 2011-03-02 |
Last Update Date | 2011-03-02 |