| NPI | 1033186507 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE LMHP2796) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NE LMFT111) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2021-04-16 |