NPI | 1104546423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19538) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C9869) |
106H00000X Marriage & Family Therapist (Licence: FL MT5112) | |
Enumeration Date | 2022-08-29 |
Last Update Date | 2025-04-21 |