| NPI | 1104979475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2002017412) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-02-06 |