| NPI | 1104163328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC2182) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC2182) |
| 106H00000X Marriage & Family Therapist (Licence: MD LC2182) | |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2013-01-08 |