| NPI | 1659818011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 5112) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 5112) |
| 106H00000X Marriage & Family Therapist (Licence: LA 5112) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |