| NPI | 1083703458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 011216) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 1016) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF 37866) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-06-08 |