| NPI | 1073847117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T1463) |
| 106H00000X Marriage & Family Therapist (Licence: CA 107464) | |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2021-11-10 |