| NPI | 1609808732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 204035) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 80) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |