| NPI | 1164791315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GU IMFT-0014) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GU 115269) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2014-07-13 |