NPI | 1003022856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AK MFT M 193) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK CDC I) |
101YM0800X Counselor, Mental Health (Licence: FL MH 2389) | |
Enumeration Date | 2007-05-15 |
Last Update Date | 2015-07-10 |