| NPI | 1104964154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 1733) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 1929) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |