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 |