| NPI | 1104369891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 3104) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 5955) | 
| 101YM0800X Counselor, Mental Health (Licence: FL MH 8746) | |
| Enumeration Date | 2016-11-29 | 
| Last Update Date | 2022-07-01 |