| NPI | 1790818771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 1640123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 513124) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |