| NPI | 1629447966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL MT3549) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MT3549) |
| 106H00000X Marriage & Family Therapist (Licence: KY MFTMFT00221521) | |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2019-04-08 |