NPI | 1972795748 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR LCSW634) |
Additional Taxonomies | 102L00000X Psychoanalyst (Licence: OR LCSW634) |
Enumeration Date | 2007-08-15 |
Last Update Date | 2007-08-15 |