| NPI | 1104000652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MD LCM630) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NE 157) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2019-02-05 |