NPI | 1114076858 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 1209) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 966) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2007-07-08 |