| NPI | 1104223155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: PA RN-255881-L) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |