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 |