| NPI | 1104909811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA 3134) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 2203783236) |
| 106H00000X Marriage & Family Therapist (Licence: LA 1029) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2017-06-02 |