| NPI | 1104207018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SD LPC667) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT1173) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-02-29 |