| NPI | 1053403212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 1168) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5076) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-01-19 |