NPI | 1104037365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4413) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 1159) |
Enumeration Date | 2007-05-26 |
Last Update Date | 2008-04-03 |