| NPI | 1124023189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002325) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: VA 0812000027) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000081) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-08 |