NPI | 1164541934 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2625) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 657) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2007-07-08 |