NPI | 1972662302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000348) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000886) |
Enumeration Date | 2006-12-08 |
Last Update Date | 2007-07-08 |