| NPI | 1063898039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT SWP-LCPC-LIC-4584) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT SWP-LMFT-LIC-4709) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |