| NPI | 1134675515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 2890) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 675) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2021-03-25 |