NPI | 1093374365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 12219A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 24778) |
Enumeration Date | 2019-06-11 |
Last Update Date | 2020-11-16 |