| NPI | 1649379389 | 
|---|---|
| Former Name | MARY VIRGINA MORIARTY | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA lw00004048) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA lw00004048) | 
| 104100000X Social Worker (Licence: WA LW00004048) | |
| Enumeration Date | 2006-09-21 | 
| Last Update Date | 2024-01-21 |