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 |