| NPI | 1144694969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MD LCM570) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LCM570) |
| 101YP2500X Counselor, Professional (Licence: MD LCM570) | |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2018-05-14 |