| NPI | 1073710307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH8213) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WV LPC1452) |
| 106H00000X Marriage & Family Therapist (Licence: FL MT2124) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |