| NPI | 1073866513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 1249) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 3869) |
| 106H00000X Marriage & Family Therapist (Licence: MS T0253) | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2019-10-08 |