| NPI | 1639265879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK LCSW297) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK LMFT613) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |