| NPI | 1629306956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| 101YM0800X Counselor, Mental Health (Licence: NC 1104808) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 1104808) | |
| 251S00000X | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2010-03-10 |