| NPI | 1023126802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2128)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 192)  | 
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2018-03-17 |