| NPI | 1174510903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701000681) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000043) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000161) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2008-07-02 |