| NPI | 1104343995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA 001264) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 006348) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |