| NPI | 1124554662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC7562) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC7562) |
| 106H00000X Marriage & Family Therapist (Licence: MD LC7562) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2022-11-10 |