| NPI | 1679534556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 3907) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 196) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2016-03-11 |