| NPI | 1609912294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 120302) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 217592) |
| 101YM0800X Counselor, Mental Health (Licence: MA 1801) | |
| 106H00000X Marriage & Family Therapist (Licence: MA 939) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-06-16 |