NPI | 1174116016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL IMT3482) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH20647) |
Enumeration Date | 2021-02-11 |
Last Update Date | 2021-02-11 |