| NPI | 1003904947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 1685125) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 493124) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-09-11 |