| NPI | 1629174040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7107123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 676124) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2008-01-18 |