| NPI | 1063676658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 136-124) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 520-125) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |