NPI | 1164060752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA MFT1469) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0018290) |
101YP2500X Counselor, Professional | |
106H00000X Marriage & Family Therapist (Licence: CO MFT.0002165) | |
Enumeration Date | 2019-12-15 |
Last Update Date | 2022-08-08 |