| NPI | 1083730816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 45-124) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 692-125) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2011-06-27 |