| NPI | 1063891992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 2314-226) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 17263-130) |
| 106H00000X Marriage & Family Therapist (Licence: WI 440-228) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |