| NPI | 1780756643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 585) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 197) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |