| NPI | 1699197087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 1478) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 459) |
| 106H00000X Marriage & Family Therapist (Licence: KS 0292) | |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2014-01-20 |