| NPI | 1760696819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 072473-1) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: NY 072473-1) |
| 106H00000X Marriage & Family Therapist (Licence: NY 072473-1) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2008-12-11 |