| NPI | 1134599921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 1604) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 2517L CAP) |
| 101YS0200X Counselor School (Licence: FL 481172 DOE) | |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |