| NPI | 1063650596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 1680) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 0070) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2018-03-17 |