NPI | 1053494443 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC-2639) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LMFT-2640) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2007-07-08 |