| NPI | 1114392693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5947) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 5947) |
| 106H00000X Marriage & Family Therapist (Licence: LA 1247) | |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2018-02-09 |