| NPI | 1629460357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR A2015) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR A2015) |
| 106H00000X Marriage & Family Therapist (Licence: OR A2015) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-06-24 |