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 |