| NPI | 1063674786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-119) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LMFT-2963) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2011-06-16 |