| NPI | 1063872828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2013035387) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2016016756) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2023-12-19 |