| NPI | 1083947543 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 1904) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 6608) | 
| Enumeration Date | 2009-09-15 | 
| Last Update Date | 2009-09-15 |