NPI | 1154791291 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2954) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 1014) |
Enumeration Date | 2015-10-01 |
Last Update Date | 2021-09-30 |