| NPI | 1063639946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2840-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2840-125) |
| 106H00000X Marriage & Family Therapist (Licence: WI 605-124) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |