| NPI | 1780956300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 1007) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT 108) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2019-10-09 |