NPI | 1649796186 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.021626) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 575228) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2022-01-31 |