| NPI | 1073738159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LCPC 66) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LMFT 23) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |