| NPI | 1760770150 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34001705A) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35000909A) | 
| Enumeration Date | 2011-07-19 | 
| Last Update Date | 2011-07-19 |