| NPI | 1982614152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 1324-123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 120-124) |
| 101YP2500X Counselor Professional (Licence: WI 934-125) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-09 |