| NPI | 1114922242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 001077) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 300125) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2007-07-09 |