| NPI | 1821197823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 2597) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 2597) |
| 106H00000X Marriage & Family Therapist (Licence: GA CSW002597) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-09-18 |