NPI | 1629135900 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2004028301) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2007-01-03 |
Last Update Date | 2012-06-22 |