| NPI | 1114200581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 41) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 330) |
| 101YP2500X Counselor, Professional (Licence: OK 1019) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |