| NPI | 1144678699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH 14480)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT 2471)  | 
| Enumeration Date | 2016-05-25 | 
| Last Update Date | 2016-05-25 |