| NPI | 1053993899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2665) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 707) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2021-04-21 |