| NPI | 1104501501 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T2816) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R7937) | 
| Enumeration Date | 2023-06-21 | 
| Last Update Date | 2025-04-04 |