| NPI | 1962618132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW7685) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA MFT 765) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |