| NPI | 1104901263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 2882-125) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 635-124) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |