NPI | 1700123700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11159) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 2815) |
Enumeration Date | 2013-01-10 |
Last Update Date | 2016-06-03 |