| NPI | 1053521328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C0168) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T0103) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |