NPI | 1144713454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001628) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1180) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2018-06-11 |