| NPI | 1154694545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2006012562) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2005037146) |
| 106H00000X Marriage & Family Therapist (Licence: KS 813) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-08-27 |