| NPI | 1679062806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV BP00944899) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV BP00944899) |
| 106H00000X Marriage & Family Therapist (Licence: WV BP00944899) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |