| NPI | 1689702896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C004083) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 857) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 02563R) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-04-06 |