| NPI | 1912056011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904005194) |
| 106H00000X Marriage & Family Therapist (Licence: 0904005194) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |