| NPI | 1700968534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003068A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001058A) |
| 106H00000X Marriage & Family Therapist (Licence: IN 35000380A) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-06-27 |