| NPI | 1023178563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 2776) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 004755) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-05-01 |