| NPI | 1982798708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 2419) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 221) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |