NPI | 1053776500 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LA 6618) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 1303) |
Enumeration Date | 2015-12-29 |
Last Update Date | 2021-09-24 |