| NPI | 1164893319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 3361) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 883) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |