NPI | 1073028759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0016497) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 106596) |
106H00000X Marriage & Family Therapist (Licence: CA 106596) | |
Enumeration Date | 2017-12-04 |
Last Update Date | 2021-11-12 |