| NPI | 1639332018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW7781F) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL SW7781) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL SW7781) | |
| 101YM0800X Counselor Mental Health (Licence: SW7781) | |
| 102L00000X Psychoanalyst (Licence: FL SW7781) | |
| 106H00000X Marriage & Family Therapist (Licence: FL SW7781) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2011-11-05 |