| NPI | 1154746329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KS 100) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 137) |
| 106H00000X Marriage & Family Therapist (Licence: MO 2003002779) | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-02-25 |