| 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 |