| NPI | 1104597673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3572) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT 42747) |
| 106H00000X Marriage & Family Therapist (Licence: IA 100819) | |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2021-09-24 |