| NPI | 1104989243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39000252A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 001193) |
| 106H00000X Marriage & Family Therapist (Licence: IN 35001454A) | |
| 106H00000X Marriage & Family Therapist (Licence: VT 100-0000038) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |